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Individual

MR. ROBERT D QUAKENBUSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4049 DAYTON XENIA RD, BEAVERCREEK, OH 45432-1992
(937) 429-8500
(937) 429-8500
Mailing address
4049 DAYTON XENIA RD, BEAVERCREEK, OH 45432-1992
(937) 429-8500
(937) 429-8500

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000000258
ANTHEM
OH
05
0861787
OH
Enumeration date
03/03/2008
Last updated
03/18/2008
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